CAJ | 학술논문

目的探讨HBV(乙型肝炎病毒)C启动子区(CP) C1673T/C1799G联合变异的生物学和临床意义.方法 136名慢性HBV感染者,包括无症状携带者(ASC) 25例,慢性乙型肝炎(CHB)38例,慢性重型乙型肝炎(CSHB) 24例,乙肝肝硬化(LC) 36例,肝细胞肝癌(HCC)13例,用半巢氏PCR的方法结合直接测序法检测HBV基因亚型及CP区变异,分析C1673T/C1799G联合变异在不同基因亚型中的发生率及与HBV复制、e抗原表达和不同慢性HBV感染疾病谱的关系.结果本组病例中,Ba亚型110例,Bj亚型1例,C1亚型7例,C2亚型8例,C1673T/C1799G联合变异发生率为80.9％,其中在Ba亚型中为96.4％,C1亚型为14.3％,C2亚型为12.5％,Ba亚型与C1和C2亚型比较,差异有统计学意义(P ＜0.0001).变异组HBV DNA载量与非变异组比较差异无统计学意义(P＞0.05);e抗原阳性组变异率为71.4％,e抗原阴性组为87.5％,两组比较差异有统计学意义(P＜0.05).从ASC、CHB、CSHB、LC到HCC组,变异的发生率差异无统计学意义(P＞0.05).结论 C1673T/C17991G联合变异常见于Ba基因亚型,该变异不影响HBV DNA的复制水平,可能与不同慢性HBV感染疾病谱无关.
목적 탐토HBV(을형간염병독)C계동자구(CP) C1673T/C1799G연합변이적생물학화림상의의.방법 136명만성HBV감염자,포괄무증상휴대자(ASC) 25례,만성을형간염(CHB)38례,만성중형을형간염(CSHB) 24례,을간간경화(LC) 36례,간세포간암(HCC)13례,용반소씨PCR적방법결합직접측서법검측HBV기인아형급CP구변이,분석C1673T/C1799G연합변이재불동기인아형중적발생솔급여HBV복제、e항원표체화불동만성HBV감염질병보적관계.결과 본조병례중,Ba아형110례,Bj아형1례,C1아형7례,C2아형8례,C1673T/C1799G연합변이발생솔위80.9％,기중재Ba아형중위96.4％,C1아형위14.3％,C2아형위12.5％,Ba아형여C1화C2아형비교,차이유통계학의의(P ＜0.0001).변이조HBV DNA재량여비변이조비교차이무통계학의의(P＞0.05);e항원양성조변이솔위71.4％,e항원음성조위87.5％,량조비교차이유통계학의의(P＜0.05).종ASC、CHB、CSHB、LC도HCC조,변이적발생솔차이무통계학의의(P＞0.05).결론 C1673T/C17991G연합변이상견우Ba기인아형,해변이불영향HBV DNA적복제수평,가능여불동만성HBV감염질병보무관.
Objective To explore the biological and clinical significance of the double mutations of C1673T/C1799G in HBV C promoter (CP).Methods Totally 136 patients were enrolled,including 25 asymptomatic carriers (AsC),38 patients with chronic hepatitis B (CHB),24 patients with chronic severe hepatitis B (CSHB),36 cases with liver cirrhosis (LC) and 13 cases with hepatocellular carcinoma (HCC).HBV subgenotypes and mutations in CP of all samples were determined by nested-PCR and direct nucleotide sequence analysis.The C to T mutation at nucleotide 1673 and C to G at nucleotide 1799 were analyzed in different subgenotypes,and the relationships of C1673T/C1799G double mutations with HBV replication,the expression of HBeAg,and with the severity of liver disease after chronic HBV infection were studied.Results Of the 136 patients,110 were subgenotype Ba,1 was Bj,7 were C1,and 18 were C2.C1673T/C1799G double mutations in Ba were determined in 106 (96.4％) samples,which was significantly higher than in C1 (14.3％) and C2 (12.5％) subgenotype (P ＜ 0.0001).In contrast to nonmutation group,HBV DNA content in mutation group had no significant difference (P ＞ 0.05).The prevalence of the mutation was lower in HBeAg positive patients (71.4％) than in HBeAg negative patients (87.5 ％) (P ＜ 0.05).The frequencies of the double mutations were not significantly different among ASC,CHB,CSHB,LC and HCC groups (P ＞ 0.05).Conclusion In Ba subgenotype,double mutations of C1673T/C1799G is much popular than in C1 and C2; the mutation has no effect on HBV replication,and may not be associated with the outcome of chronic HBV infection.